Klinik und Poliklinik für Psychiatrie und Psychotherapie der Technischen Universität München, München, Germany.
Klinik und Poliklinik für Psychiatrie und Psychotherapie der Technischen Universität München, München, Germany.
Psychiatry Res. 2014 Jun 30;217(1-2):15-9. doi: 10.1016/j.psychres.2014.02.005. Epub 2014 Feb 10.
For many psychiatric conditions outcomes of standard care still fall short of outcomes that are possible according to research literature. One of the major reasons is patient׳s non-adherence to long-term medication. We performed a mirror image interventional study involving patients suffering from affective (N=219) or psychotic disorders (N=210) who participated in an integrated care program focusing on treatment adherence. The main outcome variable was the number of inpatients days during the integrated care program compared to the time before the program. The integrated care project studied showed a drop of inpatient days of approx. 75% within the 18-months observation period for both groups. In the affective (psychotic) sample inpatients days dropped from M=47.1 days (M=62.2 days) in the 18 months before the program to M=10.8 days (M=15.3 days) during the adherence program. Patients with affective disorders additionally profited with regard to symptom reduction, quality of life and self-reported adherence. Thus, a complex intervention addressing frequent weaknesses of routine psychiatric outpatient care and focussing on adherence and linking up outpatient services is effective with regard to the reduction of inpatient days for patients with affective and patients with schizophrenic disorders.
对于许多精神疾病，标准治疗的结果仍然低于研究文献中可能的结果。其中一个主要原因是患者对长期药物治疗的不依从。我们进行了一项镜像干预研究，涉及患有情感（N=219）或精神病性障碍（N=210）的患者，他们参加了一个专注于治疗依从性的综合护理项目。主要的结果变量是综合护理项目期间的住院天数与项目前相比的变化。研究中涉及的综合护理项目显示，两组患者在 18 个月的观察期内的住院天数分别减少了约 75%。在情感（精神病性）样本中，患者在项目前的 18 个月内住院天数从 M=47.1 天（M=62.2 天）减少到 M=10.8 天（M=15.3 天）。在依从性项目期间。情感障碍患者在症状减轻、生活质量和自我报告的依从性方面也有获益。因此，针对常规精神科门诊治疗常见弱点的复杂干预措施，关注依从性并将门诊服务联系起来，对减少情感障碍和精神分裂症患者的住院天数是有效的。
